ESTRO 2025 - Abstract Book

S4128

RTT - Patient care, preparation, immobilisation and IGRT verification protocols

ESTRO 2025

found that pre-oxygenating patients can double breath hold times improving comfort and reducing treatment delivery times. In early 2024, University Hospitals Birmingham was the UK first to successfully treat using this innovative oxygen enhanced breath-hold method. This method has reduced treatment delivery time and feedback from patients has been overwhelmingly positive. We shall present our approach to implement this technique, mitigations to deliver safely oxygen on-set, methods to assess breath hold duration using SGRT (Surface-Guided Radiation Therapy), reductions in treatment times and benefits to patient experience. Material/Methods: We studied the use of 60% oxygen for 10 patients undergoing radiotherapy for lymphoma (mediastinal or gastric) or breast cancer. We used previously published exclusion criteria with additional exclusion of treatment history with Bleomycin or Amiodarone. Prior to treatment, patients participated in radiographer led coaching sessions to assess breath-holding with and without oxygen enrichment. Patients in this study received 4 minutes of pre-oxygenation (60% at 15 litres per minute) to displace nitrogen in the lungs. Staff and patient experience surveys were conducted. Results: Early data collection with the first 4 patients has shown remarkable results with patients consistently achieving breath-hold durations of one to two minutes, enabling full VMAT (Volumetric Modulated Arc Therapy) arc deliveries per breath hold. T-tests on breath-hold duration for air and 60% oxygen show that there is a significant (p<0.05) increase in breath-hold duration with 60% oxygen with a typical 78± 28% increase in time. Patients studied achieved breath-hold durations which increased from a mean of 41s (SD 22s) in room air to 71s (SD 39s) in 60% Oxygen. Patient and staff experience surveys have shown positive feedback. Conclusion: Whilst this study targets a specific group, there is great potential to apply this breath-hold technique to a broader patient cohort. The small additional overheads for pre-oxygenation and monitoring are offset by longer breath-hold durations and reduced treatment times. The potential for better treatment outcomes, increased patient satisfaction, and higher clinical throughput supports the case for integrating this method into routine clinical practice. As more data is collected, the long-term advantages could establish this technique as a valuable routine addition to modern radiotherapy.

Keywords: 60% Oxygen, breath-hold, DIBH

3615

Digital Poster Deep Inspiration Breath Hold breast radiotherapy for non-English speakers at a UK Centre Cornlia Iosub, Jo Strickland, Wendy Goldshaker, Meera Patel, Marina Khan, Deirdre Dobson Radiotherapy, Guy's & St. Thomas' NHS Foundation Trust, London, United Kingdom Purpose/Objective: At this institution, all patients diagnosed with left breast and/or internal mammary chain cancer (IMC) are referred for radiotherapy (RT) using DIBH, assisted by surface guided radiotherapy (SGRT). An exclusion criterion has been if the patient does not understand English. The UK 2021 census (Office for National Statistics, 2021) states the proportion of people from a minority ethnic background has risen in recent years. In London, 63.2% of residents identified as belonging to ‘other’ ethnic groups. In 2021 the department had 16 patients requiring interpreters for 12 different languages. Equality, Diversity, and Inclusion (ED&I) are underlying core values to our Trust. Therefore, as part of departmental development, several methods of managing DIBH for non-English speakers were evaluated.